ECG findings of acute myocardial infarction and atrioventricular block during a transseptal procedure for left atrial ablation.
We report on a patient with transient atrioventricular block and ST-segment elevation mimicking the ECG of myocardial infarction during transseptal puncture for radiofrequency catheter ablation of atrial fibrillation. Symptoms and EGG findings resolved spontaneously. A neurally-mediated mechanism, activated by the mechanical effects of the transseptal puncture on the interatrial septum and leading to coronary artery spasm, may be considered as a possible explanation of this phenomenon. Coronary artery embolism following the transseptal procedure represents an alternative mechanism. The above mechanisms could also explain the atrioventricular block.
Efremidis
Michalis
M
Second Department of Cardiology, Laboratory of Electrophysiology, Evaggelismos General Hospital of Athens, Greece. micbcar@otenet.gr
Letsas
Konstantinos P
KP
Xydonas
Sotirios
S
Koutras
Konstantinos
K
Sideris
Antonios
A
Kardaras
Fotios
F
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D001282:Atrial Flutter / Q000601:surgery*; D054537:Atrioventricular Block / Q000175:diagnosis*; D017115:Catheter Ablation; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000503:physiopathology; D004562:Electrocardiography; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors